Mortality among methicillin-resistant Staphylococcus aureus carriers in long-term care facilities

Area of Science:

• Infectious Diseases
• Geriatric Medicine
• Healthcare Epidemiology

Background:

• Limited understanding of methicillin-resistant Staphylococcus aureus (MRSA) natural course in chronic illness.
• Need to assess MRSA colonization impact on mortality in long-term care facility (LTHCF) residents.

Purpose of the Study:

• Determine the association between MRSA colonization and mortality rates in LTHCF residents.
• Identify predictors of mortality in MRSA-colonized LTHCF residents.

Main Methods:

• Multicenter, prospective, observational study.
• Classification of 413 LTHCF residents into MRSA carriers and non-carriers.
• 12-month follow-up with nasal mupirocin treatment for MRSA carriers.

Main Results:

• 93 MRSA carriers identified; 31 died during the study (11 from infection).
• Predictors of mortality included heart failure, neoplasm, MRSA carriage, COPD, stroke, low Bar-thel index, pressure ulcers, and older age.
• MRSA persistence rates were 35% at 3 months and 62.5% at 12 months.

Conclusions:

• MRSA colonization is prevalent and associated with increased mortality in frail LTHCF residents.
• Many patients remained colonized despite mupirocin treatment.
• Further investigation is required on factors promoting MRSA persistence and their effect on mortality.